BACKGROUND Transcranial direct-current stimulation (tDCS) is an easy-to-apply, cheap, and safe technique capable of affecting cortical brain activity. However, its effectiveness has not been proven for many clinical applications. OBJECTIVE The aim of this systematic review was to determine whether the effect of different strategies for gait training in patients with neurological disorders can be enhanced by the combined application of tDCS compared to sham stimulation. Additionally, we attempted to record and analyze tDCS parameters to optimize its efficacy. METHODS A search in Pubmed, PEDro, and Cochrane databases was performed to find randomized clinical trials that combined tDCS with gait training. A chronological filter from 2010 to 2018 was applied and only studies with variables that quantified the gait function were included. RESULTS A total of 274 studies were found, of which 25 met the inclusion criteria. Of them, 17 were rejected based on exclusion criteria. Finally, 8 trials were evaluated that included 91 subjects with stroke, 57 suffering from Parkinson's disease, and 39 with spinal cord injury. Four of the eight assessed studies did not report improved outcomes for any of its variables compared to the placebo treatment. CONCLUSIONS There are no conclusive results that confirm that tDCS can enhance the effect of the different strategies for gait training. Further research for specific pathologies, with larger sample sizes and adequate follow-up periods, are required to optimize the existing protocols for applying tDCS.

中文翻译：

---

神经疾病患者经颅直流电刺激与步态训练的结合：系统评价。

背景技术经颅直流电刺激（tDCS）是一种易于应用，廉价且安全的技术，能够影响皮质脑活动。但是，其有效性尚未在许多临床应用中得到证实。目的本系统综述的目的是确定与假刺激相比，tDCS的联合应用能否提高神经系统疾病患者步态训练的不同策略的效果。此外，我们尝试记录和分析tDCS参数以优化其功效。方法在Pubmed，PEDro和Cochrane数据库中进行搜索，以找到将tDCS与步态训练相结合的随机临床试验。应用了从2010年到2018年的时间顺序过滤器，并且仅包括具有量化步态功能的变量的研究。结果共发现274项研究，其中25项符合纳入标准。根据排除标准，其中17人被拒绝。最后，评估了8个试验，其中包括91名中风患者，57名帕金森氏病患者和39名脊髓损伤患者。与安慰剂治疗相比，八项评估研究中有四项没有报告其任何变量的预后都有改善。结论尚无结论性结果证实tDCS可以增强不同步态训练策略的效果。需要对具有更大样本量和足够随访时间的特定病理学进行进一步研究，以优化用于应用tDCS的现有协议。评估了8项试验，其中包括91名中风患者，57名帕金森氏病患者和39名脊髓损伤患者。与安慰剂治疗相比，八项评估研究中有四项没有报告其任何变量的预后都有改善。结论尚无结论性结果证实tDCS可以增强不同步态训练策略的效果。需要对具有更大样本量和足够随访时间的特定病理学进行进一步研究，以优化用于应用tDCS的现有协议。评估了8项试验，其中包括91名中风患者，57名帕金森氏病患者和39名脊髓损伤患者。与安慰剂治疗相比，八项评估研究中有四项没有报告其任何变量的预后都有改善。结论尚无结论性结果证实tDCS可以增强不同步态训练策略的效果。需要对具有更大样本量和足够随访时间的特定病理学进行进一步研究，以优化用于应用tDCS的现有协议。结论尚无结论性结果证实tDCS可以增强不同步态训练策略的效果。需要对具有更大样本量和足够随访时间的特定病理学进行进一步研究，以优化用于应用tDCS的现有协议。结论尚无结论性结果证实tDCS可以增强不同步态训练策略的效果。需要对具有更大样本量和足够随访时间的特定病理学进行进一步研究，以优化用于应用tDCS的现有协议。